We are all sickened by inequality at work

We are all sickened by inequality at work

Women working in the caring professions for example can lift more in a shift than a construction worker or a miner.

(AP/Ahn Young-joon)

When Babul Khan lost two of his four sons in an inferno at Gadani shipbreaking yard on 1 November 2016, it was a tragedy but it wasn’t a surprise. Like all the 26 workers who were killed when an oil tanker was blasted apart at Pakistan’s largest shipbreaking yard, 18-year-old Ghulam Hyder and 32-year-old Alam Khan were insecure workers. Disposable workers.

The yard was shut in the immediate wake of the deaths. Soon, though, it was business as usual – and that meant, inevitably, more deaths. At least five workers died in a fire on a liquefied petroleum gas (LPG) container ship at the shipbreaking yard on 9 January 2017. The yard was making money; a steady stream of horrific fatalities was just collateral damage.

Who lives and who dies at work is not an accident of chance. The emergence of increasingly precarious forms of employment in convoluted supply chains was as deliberate as it was deadly.

It creates a working world where the bad actors set a wage, conditions and employment rights benchmark which sucks down conditions across the global economy.

Maintaining a system of indecent work has always required an extra ingredient – a divided workforce. Where workers do not have a collective voice and where jobs are by design segregated by gender, race or class, those divisions can perpetuate disadvantage and leave the most exploited workers powerless while undercutting the conditions of the rest.

All this comes at a price. At the top of the workplace pecking order, those making the decisions don’t just receive multipliers more in income and perks, they get to live many years longer to enjoy them.

The impact on women

Thumb through the classic occupational medicine textbooks, and you get a picture of work related disease dominated by exposures in mines, mills and factories. Male exposures. Dust diseases like pneumoconiosis and the physical strain of hauling large weights over long hours had a devastating impact on the lives of the men studied, dramatically curtailing life expectancy.

Women worked, but were treated as ‘confounding factors’ in research. Likewise black and minority workers. It was a bias that persisted through much of the twentieth century, and it perpetuated a vision of industrial health problems that was white and male.

It was a big white lie. Women working in the caring professions for example can lift more in a shift than a construction worker or a miner, and frequently combine their work with a second unpaid shift of domestic work. From tea plantations to brick kilns to flower fields worldwide, women do arduous work, frequently with young children in tow.

A study published in the September 2016 issue of the Journal of Occupational and Environmental Medicine concluded the total hours burden borne by women who put in long hours for the bulk of their careers led to ‘alarming increases’ in life-threatening illnesses, including heart disease and cancer.

Yet even today, the occupational exposures in female dominated trades like caring and cleaning are under-researched and under-appreciated.

It may be that women, often under-represented in hazardous trades like construction and mining, are less likely to feature in the occupational fatality statistics. But occupational disease deaths dwarf the work fatalities total.

There is good reason to suppose women are every bit as vulnerable to these diseases. The chemicals are there, the musculoskeletal hazards are there, and the stresses are there. It is just the studies and the give-a-damn that is missing.

We know women’s wages are lower than men’s, not because women’s work is worth less, but because of glass ceilings and gender tramlines that keep women ‘in their place’. If society places less value on women’s work, makes fewer efforts to assess its effects and takes less care in mitigating its consequences, then that will, inevitably, be reflected in unrecognised but substantial work related ill-health.

Race compounds occupational risk

Like gender, race has been treated historically as a ‘confounder’ in occupational health research, so the literature on racial inequalities in occupational health is threadbare. But as occupational risk increases the lower you go down the social class ladder, race surely compounds this.

In the early 1970s, the US government’s occupational health research body NIOSH investigated the risks to workers on the coke ovens fuelling steel works and factories. It was apparent coke oven workers faced a greatly increased risk of lung cancer. But on closer inspection it became clear black workers were far more likely to be given the worst jobs with the highest exposures, at the top of the coke oven.

This isn’t an historical artefact. In 2011, NIOSH noted: “African-American, Hispanic, and immigrant workers are disproportionately employed in some of the most dangerous occupations. African-American males are twice as likely as non-Hispanic white males to work in service occupations and as labourers, fabricators, and operators, yet are half as likely to be in managerial or professional specialty occupations.

“The result is that the African-American injury rate is about a third higher for both African-American males and females compared to white non-Hispanic workers.”

Sometimes the process is more blatant.

In December 2009, the Studsvik Memphis Processing Facility in Tennessee, a US company that processes nuclear waste, agreed to settle compensation claims with black employees who were assigned to jobs with higher radiation exposures but who then had their dose meters doctored to show lower exposure levels.

In India, the workers employed informally as manual scavengers – removing by hand human excrement from homes – are drawn exclusively from the persecuted ‘low caste’ Dalit community.

The health consequences – constant nausea and headaches, respiratory and skin diseases, anaemia, diarrhoea, vomiting, jaundice, trachoma and deadly asphyxia – are limited entirely to this community.

‘Diseases of distress’

Any notion that knowledge and enlightenment is creating a working world that is by increments getting safer and healthier is misguided. Instead ‘ordinary’ jobs, not commonly associated with excessive dangers, are driving many workers to a state of perpetual and sometimes deadly desperation.

Reviewing evidence of a sharp spike in death rates among white working class American males, occupational health specialists at the University of Massachusetts Lowell identified job insecurity, discrimination and a lack of control at work behind an increase in ‘diseases of distress’ – alcohol and drug-related diseases and suicides.

Studies in France have estimated the annual work-related suicide toll – which has risen sharply in recent years – at several hundred and possibly thousands of deaths each year.

Reports in the United States, Australia, France, Japan, China, India and Taiwan and the UK all point to a steep rise in work-related suicides. There is a clear social class association evident and a common set of workplace abuses witnessed time and time again.

These deaths should not dismissed as a last cry for help. They are a last cry of protest. At the core of the problem is a system where workers are treated increasingly as just another component, a variable on a business spread sheet to be cut, squeezed or extended beyond operational capacity.

The tragedy is that job insecurity isn’t an irresistible force of nature. It is a choice. Work can be decent and productive and profitable. But corporate boards are judged by this year’s bottom line.

Corporate social responsibility is frequently little more than cynical public relations, not an operating imperative.

It is a perversity that the language of ‘risks and rewards’ is used to justify soaring boardroom pay packets and the growing income inequality at work. But the workers most frequently compelled to take genuine risks – to life, to limb, to health – are those who receive the lowest financial rewards.

“Unions make workplaces safer and healthier”

Low pay is in all probability the clearest indicator of the degree of health and safety risk a worker will face. Low pay affects your choices. It influences whether you work more overtime, extra shifts, report an injury, take sick leave. And it leaves you in jobs that typically have the insecure, dirty and dangerous hallmarks of risky work.

Whole categories of workers are more likely to populate the low pay classification, and have greater employment and health vulnerability as result. Migrant workers, like the captive labour from South Asia building the glistening stadiums in Qatar, face unpoliced, uncounted but shocking injury and ill-health risks. Ill-health, disability, age and a lack of employment options can also translate to fewer choices and fewer opportunities to just say no.

Workers need the added volume of a collective voice to make themselves heard. And that is where unions come in.

If you want better pay, more job security, lower injury and ill-health rates and better terms and conditions at work, then unions have a proven track record. In a virtuous circle, unions make workplaces fairer, which makes the union voice stronger, which makes workplaces safer and healthier.

There are economic benefits to an active union presence, too. A September 2013 study published in the journal Social Science & Medicine concluded: “Union density is the most important external determinant of workplace psychosocial safety climate, health and GDP.”

The paper added: “Worker health is good for the economy, and should be considered in national health and productivity accounting. Eroding unionism may not be good for worker health or the economy either.”

Unions narrow workplace inequalities, with a concomitant benefit to health. In a harsh economic climate, unions continue to make work fairer. The same collective strength that delivers better wages also makes work safer and healthier.

It is an indictment of the economic and political process that globalisation has seen a fragmentation of work and a decimation of work rights, causing inevitable harm to the public health.

But it does put in sharp relief the undeniable benefits of trade unions. It’s not just about wages, or equality or safety. It is about dignity and respect at work.
The shame is that without unions this basic decency is in increasingly short supply.

A longer version of this article was first published by Hazards Magazine.